ERYC capsules contain enteric-coated pellets of erythromycin base for oral administration.
Erythromycin is indicated in the treatment of infections caused by susceptible strains of the designated organisms in the diseases listed below:
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Upper respiratory tract infections of mild to moderate degree caused by Streptococcus pyogenes, Streptococcus pneumoniae, or Haemophilus influenzae (when used concomitantly with adequate doses of sulfonamides, since many strains of H. influenzae are not susceptible to the erythromycin concentrations ordinarily achieved).
Lower respiratory tract infections of mild to moderate severity caused by Streptococcus pneumoniae or Streptococcus pyogenes.
Listeriosis caused by Listeria monocytogenes.
Pertussis (whooping cough) caused by Bordetella pertussis. Erythromycin is effective in eliminating the organism from the nasopharynx of infected individuals rendering them noninfectious. Some clinical studies suggest that erythromycin may be helpful in the prophylaxis of pertussis in exposed susceptible individuals.
Respiratory tract infections due to Mycoplasma pneumoniae.
Skin and skin structure infections of mild to moderate severity caused by Streptococcus pyogenes or Staphylococcus aureus (resistant staphylococci may emerge during treatment).
Diphtheria: Infections due to Corynebacterium diphtheriae, as an adjunct to antitoxin, to prevent establishment of carriers and to eradicate the organism in carriers.
Erythrasma: In the treatment of infections due to Corynebacterium minutissimum.
Syphilis caused by Treponema pallidum: Erythromycin is an alternate choice of treatment for primary syphilis in penicillin-allergic patients. In primary syphilis, spinal fluid examinations should be done before treatment and as part of follow-up after therapy.
Intestinal amebiasis caused by Entamoeba histolytica (oral erythromycins only). Extraenteric amebiasis requires treatment with other agents.
Acute pelvic inflammatory disease caused by Neisseria gonorrhoeae: Erythromycin lactobionate for injection, USP followed by erythromycin base orally, as an alternative drug in treatment of acute pelvic inflammatory disease caused by N. gonorrhoeae in female patients with a history of sensitivity to penicillin. Patients should have a serologic test for syphilis before receiving erythromycin as treatment of gonorrhea and a follow-up serologic test for syphilis after 3 months.
Erythromycins are indicated for the treatment of the following infections caused by Chlamydia trachomatis: conjunctivitis of the newborn, pneumonia of infancy, and urogenital infections during pregnancy. When tetracyclines are contraindicated or not tolerated, erythromycin is indicated for the treatment of uncomplicated urethral, endocervical, or rectal infections in adults due to Chlamydia trachomatis.
When tetracyclines are contraindicated or not tolerated, erythromycin is indicated for the treatment of nongonococcal urethritis caused by Ureaplasma urealyticum.
Legionnaires' Disease caused by Legionella pneumophila. Although no controlled clinical efficacy studies have been conducted, in vitro and limited preliminary clinical data suggest that erythromycin may be effective in treating Legionnaires' Disease.
Prophylaxis
Prevention of Initial Attacks of Rheumatic Fever: Penicillin is considered by the American Heart Association to be the drug of choice in the prevention of initial attacks of rheumatic fever (treatment of Streptococcus pyogenes infections of the upper respiratory tract, e.g., tonsillitis or pharyngitis). Erythromycin is indicated for the treatment of penicillin-allergic patients.3 The therapeutic dose should be administered for ten days.
Prevention of Recurrent Attacks of Rheumatic Fever: Penicillin or sulfonamides are considered by the American Heart Association to be the drugs of choice in the prevention of recurrent attacks of rheumatic fever. In patients who are allergic to penicillin and sulfonamides, oral erythromycin is recommended by the American Heart Association in the long-term prophylaxis of streptococcal pharyngitis (for the prevention of recurrent attacks of rheumatic fever).3
To reduce the development of drug-resistant bacteria and maintain the effectiveness of ERYC and other antibacterial drugs, ERYC should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
Overdosage
In case of overdosage, erythromycin should be discontinued. Overdosage should be handled with the prompt elimination of unabsorbed drug and all other appropriate measures.
Erythromycin is not removed by peritoneal dialysis or hemodialysis.
Storage
Store at controlled room temperature 15° C to 30° C (59° F to 86° F).
Safety information
Warnings
Hepatotoxicity
There have been reports of hepatic dysfunction, including increased liver enzymes, and hepatocellular and/or cholestatic hepatitis, with or without jaundice, occurring in patients receiving oral erythromycin products.
QT Prolongation
Erythromycin has been associated with prolongation of the QT interval and infrequent cases of arrhythmia. Cases of torsades de pointes have been spontaneously reported during postmarketing surveillance in patients receiving erythromycin. Fatalities have been reported. Erythromycin should be avoided in patients with known prolongation of the QT interval, patients with ongoing proarrhythmic conditions such as uncorrected hypokalemia or hypomagnesemia, clinically significant bradycardia, and in patients receiving Class IA (quinidine, procainamide) or Class III (dofetilide, aminodarone, sotalol) antiarrhythmic agents. Elderly patients may be more susceptible to drug-associated effects on the QT interval.
Syphilis in pregnancy
There have been reports suggesting that erythromycin does not reach the fetus in adequate concentration to prevent congenital syphilis. Infants born to women treated during pregnancy with oral erythromycin for early syphilis should be treated with an appropriate penicillin regimen.
Clostridium difficile-associated diarrhea
Clostridium difficile-associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including ERYC Capsules, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile.
C. difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents.
If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated.
Drug Interactions
Serious adverse reactions have been reported in patients taking erythromycin concomitantly with CYP3A4 substrates. These include colchicine toxicity with colchicine; rhabdomyolysis with simvastatin, lovastatin, and atorvastatin; and hypotension with calcium channel blockers metabolized by CYP3A4 (for example, verapamil, amlodipine, diltiazem).
There have been post-marketing reports of colchicine toxicity with concomitant use of erythromycin and colchicine. This interaction is potentially life-threatening, and may occure while using both drugs at their recommended doses.
Rhabdomyolysis with or without renal impairment has been reported in seriously ill patients receiving erythromycin concomitantly with lovastatin. Therefore, patients receiving concomitant lovastatin and erythromycin should be carefully monitored for creatine kinase (CK) and serum transaminase levels.
Disclaimer
The information on this page is not intended to be a substitute for professional medical advice. Do not use this information to diagnose or treat your problem without consulting your doctor.
Side effects
The most frequent side effects of oral erythromycin preparations are gastrointestinal and are dose-related. They include nausea, vomiting, abdominal pain, diarrhea and anorexia. Symptoms of hepatitis, hepatic dysfunction and/or abnormal liver function test results may occur.
Onset of pseudomembranous colitis symptoms may occur during or after antibacterial treatment.
Erythromycin has been associated with QT prolongation and ventricular arrhythmias, including ventricular tachycardia and torsade de pointes.
Allergic reactions ranging from urticaria to anaphylaxis have occurred. Skin reactions ranging from mild eruptions to erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis have been reported rarely.
There have been reports of interstitial nephritis coincident with erythromycin use.
There have been reports of pancreatitis and convulsions.
There have been isolated reports of reversible hearing loss occurring chiefly in patients with renal insufficiency and in patients receiving high doses of erythromycin.
Ampicillin - Semi-synthetic penicillin, which has a wide range of effects and exhibits bactericidal effect. Suppresses the synthesis of the cell wall of bacteria: Streptococcus pneumoniae, Staphylococcus spp., Bacillus anthracis, Clostridium spp., Enterococcus faecalis, Listeria spp., Haemophilus influenzae, Neisseria meningitidis, Proteus mirabilis, Pasteurella multocida, Salmonella spp., Shigella spp., Escherichia coli, Aerobic non-spore-forming bacteria. Acid-resistant.
Viagra Super Active - an innovative formula of drug for treatment of erectile dysfunction. Drug is produced in gelatin capsules that allows to avoid emergence of heartburn or other unpleasant feelings in a stomach. Sildenafil Super Active also has a number of advantages. It is soaked quicker and works longer. The principle of action is identical with ordinary Sildenafil. Each capsule contains about 100 mg of active ingredient. That is quite enough for any man.
Cialis Oral Jelly (Orange) - a new formula of Cialis which you can have, without washing down with water. Against background of ordinary drug it differs in increased influence speed. It is prescribed for improvement of sexual endurance of men during intimate proximity. It simplifies the excitative process of penis and strengthens erection. Noticeably increases duration of sexual intercourse. Besides, the drug possesses a pleasant orange flavor.
Asacol, which is mesalamine - derivative of 5-aminosalicylic acid. It is prsecribed for treatment and remission maintenance at patients with ulcer colitis (earlier known as nonspecific ulcer colitis) of mild and moderate type.
Aygestin - the pharmaceutical preparation, containing synthetic analog of hormones of a yellow body of an ovary, it has a prominent effect on an internal cover of a uterus. It causes changes in an inside layer of a uterus, preparing it for implantation of an oospore, provides normal course of pregnancy, reduces contractility of a uterus, especially pregnant stimulates development of lactigerous parts of mammary glands. It is taken at treatment of a secondary amenorrhea, dysfunctional bleedings, polymenorrheas with the shortened phase of a yellow body, endometriosis, endometrial cancer, mastodynia and diffusion mastopathy.
Deltasone - renders an antiinflammatory, antiallergic, antishock and immunodepressive effect. It is taken for treatment of acute and chronic inflammatory diseases of joints, acute asthma, allergic diseases, skin diseases.
Diflucan - antifungal medicine, possesses highly specific action, inhibiting activity of enzymes of fungus. It is taken at systemic lesions caused by fungus including meningitis, sepsis, infections of lungs and skin as at patients with a normal immune response, and at patients with various forms of immunosuppression.
Elavil - antidepressive medicine. Renders also some analgesic, H2-histamineblocking and antiserotonin action, promotes elimination of bedwetting and reduces appetite. It is taken at Depressions (especially with anexiety, agitation and sleep disorders, including children's age, endogenous, involutional, reactive, neurotic, medicinal, at organic lesions of a brain, alcoholic abstinence), schizophrenic psychoses, mixed emotional frustration, behavior disorders, night enuresis, nervous bulimia, chronic pain syndrome.
Fluoxetine is an antidepressant group of selective serotonin reuptake inhibitors. It has a timoanaleptic and stimulating effect. It is used for depression of various genesis, obsessive-compulsive disorders, bulimic neuroses.
Mobic is a nonsteroidal anti-inflammatory drug, which has anti-inflammatory, antipyretic, analgesic effect. It belongs to the class of oxicams; derived from the anoliefo acid. Used in symptomatic treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis (Bekhterev's disease) and other inflammatory and degenerative diseases, accompanied by pain syndrome.
Nootropil improves cognitive processes, memory, attention, and mental performance.
Nootropilum affects the CNS, by changing the speed of propagation of the excitation in the brain, improves metabolic processes in nerve cells, improves by acting on the rheological characteristics of blood and causing no vasodilatory action.
The drug is a prodrug and is activated in the acidic environment of the secretory tubules in the parietal cells. It reduces basal and stimulated secretion regardless of the nature of the stimulus. Prescribed in case of erosive ulcerative diseases of the gastrointestinal tract and eradication of Helicobacter pylori in infected patients with gastric and duodenal ulcer.
The drug has a thymoleptic and anxiolytic effect. Prescribed for the treatment of depressions of various origins, enuresis including the night one.
Tenorminis a cardioselective beta-adrenoblocker. It is based on a substance called Atenolol, which blocks nerve impulses, which leads to a decrease in the frequency and strength of the heartbeat. Atenolol has antihypertensive (lowers pressure), antianginal (eliminates the symptoms of myocardial ischemia) and antiarrhythmic (eliminates heart rhythm disturbances) by action.
Vastarel - the main substance of the drug is trimetazidine, which is used for the prevention of angina attacks in IHD, as well as in vertigo caused by violations of cerebral circulation, Meniere's disease, noise in the ears. It is believed that the beneficial effect of trimetazidine in myocardial ischemia is mainly associated with its antioxidant and antihypoxic properties and cytoprotective effects on the function of cardiomyocytes.
Zestril is an angiotensin-converting enzyme inhibitor (ACE). It works by relaxing the blood vessels. This helps lower blood pressure. It is used in the treatment of high blood pressure, alone or in conjunction with other medicines.
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FML (Fluorometholone) Forte is a topical drug that belongs to the corticosteroid group of medicines. Its aim is to cure various eye problems connected with injury and inflammation. It is effective in case of bulbar conjunctiva and palpebral conjunctiva. The suspension remedies eye swelling, itching, irritation, and redness. These eye drops are not recommended to people who wear contact lenses daily. If a patient must use the drops, it’s necessary to replace contact lenses with glasses or just not to wear them during the medication.
An antifungal agent from the group of imidazole derivatives for external and local applications reduces the synthesis of ergosterol, which is a part of the cell membrane of the microbial wall and leads to a change in its structure and properties. In fungicidal concentrations, it interacts with mitochondrial and peroxidase enzymes, leading to an increase in the concentration of hydrogen peroxide to toxic levels, which also contributes to the destruction of fungal cells. The pills are active against pathogenic dermatophytes, pathogens of multi-colored lichen, erythrasma, gram-positive and gram-negative bacteria.
It has a direct influence on muscles, mainly of arterial vessels over nitric receptor situated in blood vessels. Its active component is transformed into oxide in smooth muscles that effect prompts the activity of guanylate cyclases. It is crucial for the creation of cyclic guanosine monophosphate (relaxation mediator). The drug influence the processes in the central vascular system and heart activity. The nature and force of the influence of nitroglycerin on the cardiac organ and vessels depend on the cooperation of essential actions.
Zyvox is a synthetic medicine with the increased antibacterial effectiveness. It is mostly used in the treatment of pulmonary and skin diseases caused by a wide range of Gram-positive species. In current medicinal practice, Zyvox often plays a role of the drug of last resort, since it is intended for use in people suffering from multidrug-resistant infections. The extremely high efficiency of this medicine makes it a popular choice in the treatment of severe bacterial infections and simultaneously limits its use against low-hazard infections in order to avoid propagation of resistant microorganisms.
Product description
Alfacip is an active metabolite of Alfacip, which performs important functions in regulation of the calcium balance and the bone metabolism. (Hypocalcemia; Osteodystrophy; secondary hyperparathyroidism;)
